Association between Cardiac Troponin-I and Short-Term Outcomes in Subarachnoid Hemorrhage: A Prospective Observational Study

Abstract

Background: Subarachnoid hemorrhage (SAH) is a catastrophic neurological event, which is associated with significant medical complications. Cardiac troponin I(cTnI) release occurs frequently after SAH and has been associated with a neurogenic form of myocardial injury. The aim of the study was to find out the association of serum cardiac troponin I and short term outcome in patients with Subarachnoid haemorrhage. Methods: This prospective observational study was carried out in the department of Neurology, Neurosurgery and Medicine in Dhaka Medical College & Hospital, Dhaka, Bangladesh over a period of two years starting from July, 2022 to June, 2024. A total of 95 patients suffering from subarachnoid haemorrhage confirmed by CT scan of head were included in this study. The patients were divided in to the Group I= SAH with cTnI <0.3 ng/ml; n=47 and Group II= SAH with cTnI ³ 0.3 ng/ml; n=48 groups, according to Troponin I level measured within 72 hours after the incident. Results: The mean age of the study population in Group I and Group II were 50.51±9.13 vs 57.58±10.63 years (p=0.001). The mean GCS in Group I and Group II were 13.85±1.41 vs 12.20±2.68 (p=0.001). The mean Hunt and Hess scale were 2.55±0.65 vs 3.15±0.77 (p=0.001) in Group I and Group II respectively. The mean serum cardiac troponin I was 0.12±0.05 vs 0.65±0.36 (p=0.001) in Group I and Group II and 0.25±0.22 in independent, 0.35±0.24 dependent and 0.86±0.45 in death (p=0.001). Majority (83.0%) patients had good outcome in serum cardiac troponin I <0.30 and 57.4% in serum cardiac troponin I ³0.30. The difference of was statistically significant between two groups (OR=3.79; 95%CI 1.34-11.00, p<0.05). Conclusion: Measurements of serum troponin I reveal a higher incidence of myocardial injury in patients with SAH. Raised serum cardiac troponin I is associated with more severe neurological injury.